Provider Demographics
NPI:1437685641
Name:SNYDER, KATHLEEN N (COTA/L)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:N
Last Name:SNYDER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA/L
Mailing Address - Street 1:3303 NORTHLAND DR.
Mailing Address - Street 2:STE. 312
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731
Mailing Address - Country:US
Mailing Address - Phone:512-291-2669
Mailing Address - Fax:
Practice Address - Street 1:3303 NORTHLAND DR
Practice Address - Street 2:STE. 312
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4945
Practice Address - Country:US
Practice Address - Phone:512-291-2669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-08
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3875224Z00000X
TX214482224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant